**5. Conclusions**

Findings from these systematic reviews and meta-analyses indicate that there is moderate to high strength evidence that several Ayurvedic herbal preparations, i.e., guggulu, garlic, and black cumin, are safe and effective in reducing high levels of cholesterol to a moderate extent. The data sugges<sup>t</sup> that these preparations may be used as first-line therapies or adjuncts to conventional care. We encourage future research to pursue randomized clinical trials with a larger sample size, longer durations, and with clinical outcomes of cardiovascular disease. In addition to the herbs studied, future randomized controlled trials are needed to investigate the efficacy of other Ayurvedic herbal preparations such as Arjuna, Triphala, and Amla in patients with hypercholesterolemia.

**Author Contributions:** Conceptualization, D.G. and R.H.S.; Methodology, D.G. and R.H.S.; Software, D.G.; Data Analysis, D.G.; Visualization, D.G; Resources, D.O.-J. and S.R.; Writing—Original Draft Preparation, D.G.; Writing—Review & Editing, R.V.; Supervision, R.H.S. All authors have read and agreed to the published version of the manuscript.

**Funding:** The study received the Cochrane Complementary Medicine bursary award for the year 2015.

**Acknowledgments:** The authors appreciate administrative contributions of John Salerno.

**Conflicts of Interest:** The authors declare no conflict of interest.
